Waste transfer note
A Description of the waste
- Description
- Left blank to fill in
- List of Waste code(s)
- Left blank to fill in
- How it is contained
- □ Loose □ Sacks □ Skip □ Drum □ Other
- How much
- Left blank to fill in
B Current holder of the waste (transferor)
- Name and company
- Left blank to fill in
- Address
- Left blank to fill in
- SIC code (2007)
- Left blank to fill in
- Acting as
- □ Producer □ Importer □ Transporter □ Local authority □ Permit holder □ Registered exemption □ Registered carrier □ Registered broker or dealer
- Permit or registration no.
- Left blank to fill in
- Waste hierarchy
- □ By signing in section D, I confirm that I have fulfilled my duty to apply the waste hierarchy as required by regulation 12 of the Waste (England and Wales) Regulations 2011.
C Person collecting the waste (transferee)
- Name and company
- Left blank to fill in
- Address
- Left blank to fill in
- Acting as
- □ Producer □ Importer □ Transporter □ Local authority □ Permit holder □ Registered exemption □ Registered carrier □ Registered broker or dealer
- Permit or registration no.
- Left blank to fill in
D The transfer
- Address of transfer
- Left blank to fill in
- Date and time
- Left blank to fill in
- Broker or dealer, if any
- Left blank to fill in
Transferor’s signature
Name and company
Transferee’s signature
Name and company